Tinnitus Research Paper

Tinnitus: Steps to take, drugs to avoid
Most people have experienced Tinnitus, that annoying ringing in your ears after a night out at a concert or a loud sport event, but for some people tinnitus is an annoying sensation that does not go away.
Around 50 million people in the U.S. experience some form of tinnitus, the numbers are actually on the rise with a possible correlation to increased use of personal music devices. People describe Tinnitus as a ringing, buzzing, chirping, hissing, whistling, humming or another repetitive sound. It is usually bilateral and is tends to be intermittent versus continuous. Severity of tinnitus can range from simply noticing it to people having substantial adverse effects. Tinnitus is usually divided into subjective or objective with objective being less common but usually
having an identifiable cause and correctable source. Pulsatile or rhythmic tinnitus can be a type of objective tinnitus that is caused by arteriovenous fistula, arteriovenous malformation, cerebral aneurysm, arterial bruit or another vascular lesion.
Tinnitus is frequently associated with some hearing loss due to disruption in the normal suppression of neuronal activity in the central nervous system. Sensorineural hearing loss is more common over conductive hearing loss and is irreversible. Damage to stereocillia cells in the cochlear cells triggers release of neurotransmitters that activate the 8th cranial nerve and cause abnormal excitation, giving the perception of sound in a quiet environment. Most sensorineural hearing loss is due to prolonged exposure to loud noise but presbycussis also has clinical features similar to noise induced hearing loss.
Evaluation of tinnitus can start with a primary care provider performing a thorough history and physical, including using the Weber and Rinne tests. Auscultation over vascular structures and screening with a handheld tympanometer are usually done. A T.F.I, tinnitus function index, is also filled out by the patient. Completing a thorough medication evaluation to look for any ototoxic medications is an important step. Generally, patients are referred to audiology for a more in depth, focused assessment including pure-tone thresholds, speech thresholds and speech discrimination testing. Imaging such as CT, or MRI is not done routinely but is done if patients are reporting pulsatility.
Treatment focuses on prevention and trying to protect hearing by reducing noise levels and exposure to noise.
Some treatment options are cognitive behavioral therapy and tinnitus retraining therapy. The evidence supporting medication use to help with tinnitus is weak and as of today there are no drugs FDA approved for tinnitus. Medications with promising trials are Acamprosate, which is used in alcohol rehab, benzodiazepines, lidocaine, oral misprostol, antidepressants and supplements such as Ginkgo biloba, melatonin and Zine. Trial of a hearing aid is also a non-invasive first line intervention.
The American Tinnitus Association recommends trying to eliminate potential aggravating factors such as salt, artificial sweeteners, sugar, alcohol, tobacco and caffeine.
My mom suffers from tinnitus which is why I choose to research this topic. She tells me that it can be super frustrating and that even after she was evaluated there was not a lot of options to help her. I thought the article was well written and easy to understand. It contained a lot of information. I was surprised by some of the medications they have trialed such as lidocaine and oral
misoprostol.